Glucose Intolerance: Causes, Effects, and Management Strategies

Impaired glucose tolerance

1.
If eating a bowl of white rice results in a blood sugar level of around 169 two hours after the meal, while consuming steamed vegetables and wonton soup leads to a blood sugar level of 131 two hours later, does this indicate impaired glucose tolerance?
2.
If one increases physical activity and controls their diet (by reducing refined foods), can they return to normal glucose tolerance, or is impaired glucose tolerance irreversible?
3.
Do normal individuals maintain blood sugar levels within the normal range regardless of what they eat, even after consuming a large bowl of rice? Thank you.

Miss Chen, 30~39 year old female. Ask Date: 2015/12/19

Dr. Xiao Yongxun reply Internal Medicine

1.
Generally, normal postprandial blood glucose levels are less than 140 mg/dL.
If the levels are between 140 mg/dL and 200 mg/dL, it is referred to as impaired glucose tolerance.
Of course, if postprandial blood glucose is greater than or equal to 200 mg/dL, diabetes mellitus should be suspected.
Clinically, to diagnose diabetes, physicians often have fasting patients drink a glucose solution containing 75 grams of glucose; if two tests show postprandial plasma glucose levels ≥200 mg/dL, a diagnosis of diabetes can be made.
If you measure your postprandial blood glucose two hours after eating, the postprandial blood glucose level after consuming white rice suggests impaired glucose tolerance, while the levels after eating steamed vegetables and wonton soup do not meet the criteria for impaired glucose tolerance.
This seems reasonable.
In clinical practice, foods like white rice, white bread, and steamed buns are considered high glycemic index foods, which naturally lead to higher postprandial blood glucose levels; whereas steamed vegetables and wonton soup contain carbohydrates, proteins, and fiber, resulting in a relatively lower glycemic index and consequently lower postprandial blood glucose levels.
However, if you consume a large quantity of wontons, your postprandial blood glucose may still rise.
Therefore, to determine whether you have impaired glucose tolerance, it is best to undergo testing at a hospital following standard procedures for an accurate diagnosis.
2.
Increasing physical activity, reducing the intake of refined foods, especially avoiding overeating and excessive consumption of high glycemic index foods, getting enough sleep, and achieving moderate weight loss can improve blood glucose levels.
Mild diabetes can improve to impaired glucose tolerance, and impaired glucose tolerance can improve to normal levels.
This means that the development of diabetes is not an all-or-nothing phenomenon or a sudden occurrence; rather, it is a gradual process.
Therefore, it is essential to consistently change lifestyle habits, dietary practices, and maintain regular exercise.
3.
In normal individuals, if insulin secretion is sufficient, consuming a large bowl of rice may still result in normal blood glucose levels.
However, due to aging, bodily deterioration, and potential pancreatic decline, blood glucose levels may gradually increase over time.
This explains why the prevalence of diabetes increases with age.

Reply Date: 2015/12/19

More Info

Understanding glucose intolerance is crucial for managing potential diabetes and maintaining overall health. Let's break down your questions regarding glucose intolerance, its implications, and management strategies.

1. Is a post-meal blood sugar of 169 mg/dL after eating a bowl of white rice and 131 mg/dL after eating vegetables and wonton soup indicative of glucose intolerance?
A blood sugar level of 169 mg/dL two hours after eating a bowl of white rice is above the normal range, which is typically below 140 mg/dL for a two-hour postprandial test. This suggests that your body may not be processing glucose effectively, indicating a potential glucose intolerance. On the other hand, a blood sugar level of 131 mg/dL after consuming vegetables and wonton soup is closer to the normal range, but still on the higher side. This variability in blood sugar responses to different meals can be a sign of insulin resistance or impaired glucose metabolism, which are precursors to diabetes.

2. Can increased exercise and dietary control restore normal glucose tolerance, or is glucose intolerance irreversible?
The good news is that glucose intolerance can often be improved or even reversed through lifestyle changes. Regular physical activity enhances insulin sensitivity, allowing your body to use glucose more effectively. Additionally, controlling your diet—especially reducing the intake of refined carbohydrates and sugars—can significantly impact your blood sugar levels. A balanced diet rich in whole foods, fiber, lean proteins, and healthy fats can help stabilize blood sugar levels. While some individuals may have a genetic predisposition to diabetes, many can manage or reverse glucose intolerance through these lifestyle modifications. However, it’s essential to monitor your blood sugar levels regularly and consult with a healthcare provider for personalized advice.

3. Do normal individuals maintain blood sugar levels within the normal range regardless of food intake?
Generally, healthy individuals can maintain their blood sugar levels within a normal range after consuming various foods, including larger portions of carbohydrates. This is due to their efficient insulin response, which helps regulate blood sugar levels effectively. However, even in healthy individuals, the type of food consumed can influence blood sugar levels. For instance, meals high in refined sugars or carbohydrates may cause a temporary spike in blood sugar, but the body typically compensates by releasing insulin to bring levels back down. In contrast, those with glucose intolerance or insulin resistance may experience prolonged elevated blood sugar levels after similar meals.

In conclusion, monitoring your blood sugar levels and understanding how different foods affect your glucose response is vital. If you suspect glucose intolerance, it’s advisable to consult with a healthcare professional for further testing and personalized management strategies. Regular exercise, a balanced diet, and lifestyle modifications can significantly improve your glucose metabolism and overall health.

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